Lloyd Owen, Ownsworth Tamara, Fleming Jennifer, Jackson Megan, Zimmer-Gembeck Melanie
School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Brisbane, Queensland, Australia.
Queensland Paediatric Rehabilitation Service, The Queensland Children's Hospital, Children's Health Queensland, Brisbane, Queensland, Australia.
J Neurotrauma. 2021 Mar;38(5):616-627. doi: 10.1089/neu.2020.7191. Epub 2021 Jan 5.
Children and adolescents with traumatic brain injury (TBI) can experience impaired self-awareness, or difficulty in accurately perceiving their personal abilities. This study aimed to identify the neuro-developmental and socio-environmental factors associated with self-awareness impairment and determine how self-awareness is associated with psychosocial functioning. Parents and their children age 8-16 years with TBI ( = 107, 65.4% male, mean [M] age = 12.66 years, standard deviation [SD] = 2.6 years) were consecutively recruited from an outpatient clinic over a 4-year period. Children completed the Paediatric Awareness Questionnaire (PAQ) to report their functional abilities, and the Beck Youth Inventories to report their self-concept, and anxiety and depression symptoms. Parents completed the PAQ and measures of family functioning, parenting style, and children's emotional and behavioral problems. Self-awareness impairments were defined as more negative parent-child discrepancy scores on the PAQ. Younger age at injury, more severe injury, and more family dysfunction were significantly associated with poorer self-awareness. Poorer self-awareness was associated with worse parent-rated child adaptive functioning and emotional and behavioral problems. However, poorer self-awareness was also significantly associated with more positive self-concept and fewer symptoms of depression and anxiety as rated by children. Overall, impaired self-awareness seems to be both a liability and a benefit depending on the reporter (parent or child) and outcome of interest (adaptive function/behavior or self-concept/mood).
患有创伤性脑损伤（TBI）的儿童和青少年可能会出现自我意识受损，即难以准确感知自己的个人能力。本研究旨在确定与自我意识受损相关的神经发育和社会环境因素，并确定自我意识与心理社会功能之间的关联。在4年的时间里，从一家门诊诊所连续招募了父母及其8至16岁患有TBI的子女（n = 107，男性占65.4%，平均年龄[M]=12.66岁，标准差[SD]=2.6岁）。儿童完成了儿童意识问卷（PAQ）以报告其功能能力，以及贝克青少年量表以报告其自我概念、焦虑和抑郁症状。父母完成了PAQ以及家庭功能、养育方式和儿童情绪及行为问题的测量。自我意识受损被定义为PAQ上亲子差异得分更负面。受伤时年龄较小、损伤更严重以及家庭功能障碍更多与较差的自我意识显著相关。较差的自我意识与父母评定的儿童适应性功能以及情绪和行为问题较差有关。然而，较差的自我意识也与儿童评定的更积极的自我概念以及更少的抑郁和焦虑症状显著相关。总体而言，自我意识受损似乎既是一种负担也是一种益处，这取决于报告者（父母或儿童）以及所关注的结果（适应性功能/行为或自我概念/情绪）。
